Long-Term Outcome After Intensive Stroke Rehabilitation

Background: Ischemic stroke is the main cause of adult disability, with up to 25% of patients dying within the first year. In Germany, 4/10 patients receive in-hospital rehabilitation after acute stroke. Therefore, the aim of this study was to examine the association between modern neurological rehabilitation and the outcomes of patients with ischemic stroke. Methods: In our single-centre, prospective observational study, we included patients with ischemic stroke between March 2023-June 2025. Within the first year after discharge, we conducted telephone surveys, recording survival status, modified Rankin Scale score (mRS), and quality of life using EQ-5D-5L. Favourable outcomes were defined as mRS 0-2. Predictors of mortality and favourable outcomes after 12 months were calculated using multiple logistic regression. Results: We included 180 patients with ischemic stroke and complete one-year follow-up. Median age was 81 years, median Barthel Index at admission was 15 and median Charlson Comorbidity Index (CCI) was 4 points. Mortality during rehabilitation was 3.3% and 20.6% at 1 year. Only 10% achieved a favourable outcome after 12 months. Predictors of mortality were CCI (OR: 1.27 (1.01-1.61)) and discharge home (OR: 0.18 (0.06-0.48)). Predictors for favourable outcome were age (OR: 0.92 (0.87-0.97)), length of stay in rehabilitation (OR: 0.94 (0.91-0.97)) and weekly duration of neuropsychology (OR: 2.79 (1.27-6.66)). Conclusions: Multimorbid patients needing institutional care appear to have greater risk of death, while outcomes of younger patients, who needed less rehabilitation and had more consultation with neuropsychology, were associated with higher levels of independency after one year.